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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Service User Agreements and Termination Policy

1. Purpose

The purpose of this policy is to set out how {{org_field_name}} establishes, reviews, varies, suspends and terminates service user care and support agreements for people receiving supported living services in England. The policy ensures compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the Care Quality Commission (Registration) Regulations 2009, the Care Act 2014, the Mental Capacity Act 2005, the Equality Act 2010, the Human Rights Act 1998, UK GDPR and the Data Protection Act 2018. This policy promotes fairness, transparency, person-centred care, continuity of care, safeguarding, dignity, choice and control.

2. Scope

This policy applies to all staff, service users, families, advocates, and external agencies involved in the admission, agreement, and termination process within {{org_field_name}}.

This policy applies only to the care and support agreement between the service user and {{org_field_name}}. It does not replace, vary or terminate any tenancy agreement, licence agreement, occupancy agreement or housing-related contract. In supported living, the person’s right to occupy their home must remain legally and practically separate from the provision of regulated personal care. Any issue relating to tenancy, rent, housing management, eviction or possession proceedings must be dealt with separately by the landlord, housing provider or other legally responsible party and must not be used to restrict the person’s access to assessed care and support.

This policy covers:

• The process of developing a Service User Agreement
• The rights and responsibilities of the service user and provider
• The grounds for termination of services
• The procedures for ending a service user’s agreement
• Managing disputes and appeals
• The separation between care and support agreements and housing or occupancy agreements
• Mental capacity, consent and best interests requirements when agreements are made or changed
• Advocacy, communication support and reasonable adjustments
• CQC notification, duty of candour and safeguarding responsibilities where termination or withdrawal of support involves risk
• Continuity of care and safe transition planning with commissioners, local authorities, ICBs and other professionals where applicable

3. Related Policies

• Person-Centred Care Policy (SL07)
• Dignity and Respect Policy (SL08)
• Safeguarding Adults from Abuse and Improper Treatment Policy (SL13)
• Complaints and Appeals Policy (SL14)
• Mental Capacity and Deprivation of Liberty Safeguards Policy (SL39)
• Good Governance Policy (SL04)
• Admissions and Assessment Policy
• Care Planning and Risk Assessment Policy
• Equality, Diversity and Human Rights Policy
• Mental Capacity Act and Best Interests Decision-Making Policy
• Accessible Information and Communication Policy
• Duty of Candour Policy
• Records Management and Data Protection Policy
• Finance, Fees and Debt Management Policy
• Positive Behaviour Support Policy, where applicable
• Incident Reporting and CQC Notifications Policy
• Business Continuity Policy
• Transition, Discharge and Transfer of Care Policy

4. Policy Statement

{{org_field_name}} is committed to ensuring that all individuals supported by the service receive care and support in a fair, respectful, and transparent manner. This policy ensures that service user agreements are clear, legally compliant, and person-centred. Termination of services will only occur following due process and as a last resort.

4.1 Supported Living Principles

{{org_field_name}} recognises that supported living is based on the person having choice and control over their home, daily life, care and support. The care and support agreement must be separate from any tenancy, licence or occupancy agreement. A person must not be required to receive care from {{org_field_name}} as a condition of occupying their home unless this is part of a lawful and transparent arrangement that has been properly assessed, commissioned and explained.

The person must be supported to understand their agreement, including what support will be provided, how it will be reviewed, how concerns can be raised, how the agreement may be changed or ended, and what safeguards will apply. Information must be provided in a format the person can understand, including easy read, large print, translated information, communication aids, interpreter support or advocacy where required.

5. Service User Agreement

A Service User Agreement is a formal care and support agreement that explains the regulated and non-regulated care and support services that {{org_field_name}} will provide to the person. It is separate from any tenancy, licence, occupancy agreement, rent agreement, housing management agreement or arrangement with a landlord or housing provider.

This document will:

• Be written in plain, accessible language.
• Detail the services provided, including support levels, staffing, and any additional services.
• Outline the responsibilities of both the service user and {{org_field_name}}.
• Clearly define fees and payment arrangements, where applicable.
• Include a section on complaints and dispute resolution.
• Specify the grounds and procedures for termination.
• State whether {{org_field_name}} is providing the regulated activity of personal care and identify any non-regulated support provided.
• Confirm that the agreement does not create, remove or vary any tenancy, licence or occupancy rights.
• Explain how the person’s assessed needs, preferences, outcomes, risks, communication needs, cultural needs and reasonable adjustments have informed the agreement.
• Identify who is responsible for funding, invoicing and payment, including whether services are funded by the local authority, NHS/ICB, direct payment, personal budget, self-funding arrangement or another lawful funding route.
• Explain how changes to funding, commissioned hours or assessed needs will be managed safely.
• Explain how the person can access advocacy, complaints support, safeguarding support and independent advice.
• Explain how records will be kept, shared and protected in accordance with UK GDPR, the Data Protection Act 2018 and confidentiality requirements.
• Explain what will happen if the agreement is suspended, varied or ended, including the steps {{org_field_name}} will take to reduce risk and support continuity of care.

5.1 Developing the Agreement

• Before an agreement is signed, {{org_field_name}} will complete or review an assessment of the person’s needs, preferences, communication needs, risks, mental capacity, consent, outcomes, equality needs, cultural needs, health needs, safeguarding considerations and any commissioning or funding requirements. The assessment must be proportionate, person-centred and completed with the person and, where appropriate, their family, advocate, attorney, deputy, commissioner or other lawful representative.
• The person must be given enough information, time and support to understand the agreement before signing or agreeing to it.
• Where the person may lack capacity to understand, agree to or terminate the agreement, a decision-specific mental capacity assessment must be completed in accordance with the Mental Capacity Act 2005.
• Where the person lacks capacity, any agreement or significant change must be made in the person’s best interests, involving those legally authorised or appropriate to consult, such as an attorney, deputy, advocate, family member, commissioner or social worker.
• Staff must not assume that a family member can sign or agree on behalf of the person unless they have lawful authority or the decision is being made through a valid best interests process.
• Where the person has substantial difficulty being involved and has no appropriate person to support them, the need for an independent advocate must be considered under the Care Act 2014.
• The agreement must be consistent with the person’s care plan, risk assessments, funding arrangements and any local authority or NHS/ICB commissioned support plan.

• The agreement is developed in collaboration with the service user, their family, or legal representative.
• A copy of the signed agreement will be provided to the service user and stored securely in their records.
• Any changes to the agreement must be communicated and documented.

5.2 Capacity, Consent and Representation

{{org_field_name}} will presume that each person has capacity to make decisions about their care and support agreement unless there is evidence to suggest otherwise. Capacity must be assessed only where there is a specific concern and must relate to the specific decision at the specific time.

Where the person has capacity, their consent must be obtained before the agreement is entered into, varied or ended, unless there is a lawful reason to act otherwise. Where the person lacks capacity, decisions must be made in accordance with the Mental Capacity Act 2005 and in the person’s best interests. Any attorney, deputy or other lawful representative must act within the scope of their legal authority.

If there is disagreement about capacity, best interests, risk, funding or termination, {{org_field_name}} will seek a multi-agency review and, where necessary, legal or safeguarding advice before making any final decision to end or materially change support.

5.3 Accessible Information and Reasonable Adjustments

{{org_field_name}} will provide the agreement and related information in a format the person can understand. This may include easy read, large print, audio, translated information, interpreter support, communication aids, visual information, social stories or support from an advocate or communication partner.

Reasonable adjustments must be made where the person has a disability, sensory impairment, cognitive impairment, learning disability, autism, mental health need, literacy need or language need. Staff must record what adjustments were offered and provided.

6. Managing Service User Agreements

6.1 Reviewing Agreements

All agreements must be reviewed at least annually and sooner whenever there is a relevant change in the person’s needs, preferences, risks, funding, capacity, consent, communication needs, safeguarding circumstances, accommodation status, commissioned support, legal representative arrangements or ability of {{org_field_name}} to provide safe and effective care.

The review must involve the service user and their representative where appropriate.

Any amendments must be documented, explained to the person in an accessible format, agreed by the person where they have capacity, or authorised through a lawful representative or best interests process where they lack capacity. A copy of the revised agreement must be provided to the person and, where appropriate, their lawful representative, commissioner or funder.

6.2 Temporary Suspension or Variation of Services

In some circumstances, services may be temporarily suspended, reduced, increased or varied rather than terminated. This may include hospital admission, respite, extended absence, temporary changes in funding, temporary risk management arrangements, safeguarding enquiries, environmental risks, staff safety concerns, or a short-term inability to deliver the agreed support safely.

Any suspension or variation must be risk assessed, clearly recorded and reviewed regularly. {{org_field_name}} must consider the person’s safety, wellbeing, wishes, capacity, communication needs, safeguarding needs and continuity of care. The person, their representative, commissioner, social worker, housing provider and other relevant professionals must be involved where appropriate.

Suspension must not be used as a punishment or as a way to avoid the provider’s responsibilities. Services must resume as soon as it is safe, lawful and practicable to do so, or a safe alternative arrangement must be agreed.

7. Grounds for Termination

Termination of a care and support agreement must only occur where there is a lawful, fair, transparent and proportionate reason, and after all reasonable steps have been taken to resolve concerns, reduce risks, make reasonable adjustments and explore alternatives. Termination must be a last resort unless there is an immediate and serious risk to life, health, safety or wellbeing that cannot be managed safely by {{org_field_name}}.

Termination of a service user’s agreement may occur under the following circumstances:

• Service user request: The individual chooses to leave the service.
• Change in needs: The person’s care needs exceed what {{org_field_name}} can provide safely.
• Safeguarding concerns: Where the safety of the service user or others is at significant risk.
• Non-payment of fees: Where the person is responsible for payment and fees remain unpaid after invoices, reminders, reasonable discussion, affordability considerations, funding checks and appropriate debt management steps have been completed. Services must not be withdrawn in a way that places the person at avoidable risk, and commissioners or safeguarding agencies must be involved where non-payment may affect essential care.
• Refusal or non-engagement with essential care: Where the person with capacity refuses essential care or support, or where refusal occurs in circumstances requiring capacity, best interests, safeguarding or risk review. The provider must explore the reasons for refusal, communication needs, trauma, mental health, distress, coercion, environmental factors and less restrictive alternatives before considering termination.
• Serious or repeated breach of the agreement: Including behaviour that creates a serious risk to the person, staff or others, but only after positive behaviour support, risk assessment, safeguarding referral, reasonable adjustments, multi-agency review and alternative support options have been considered where appropriate.
• Provider decision: If {{org_field_name}} is unable to continue providing services due to operational reasons.
• The person chooses to end care and support from {{org_field_name}}, provided they have capacity to make that decision or the decision is otherwise lawfully made.
• The person’s assessed needs have changed and {{org_field_name}} can no longer meet those needs safely, effectively or within its CQC registration, staffing model, competence, insurance or commissioned service specification.
• The commissioner or funder lawfully ends, changes or transfers the commissioned package, provided safe transition arrangements are agreed.
• The service is no longer able to operate safely because of serious environmental, staffing, contractual, legal, regulatory or business continuity reasons, and all reasonable alternatives have been explored.
• There is a serious safeguarding, criminal, regulatory or court-related reason requiring immediate review or withdrawal from the agreement.

Termination of the care and support agreement must not be used to evict, threaten eviction, remove occupancy rights, force a move, restrict choice of provider or pressure a person to accept care they do not want. Any housing or occupancy issue must be managed separately from this policy.

8. Termination Process

8.1 Notice Periods

Wherever possible, {{org_field_name}} will provide at least 28 calendar days’ written notice before ending a care and support agreement. A longer notice period may be required where this is stated in the individual agreement, commissioning contract or funding arrangement, or where needed to ensure safe transition.

The written notice must include:

• the reason for the proposed termination;
• the proposed termination date;
• the risks identified and steps taken to reduce them;
• the alternatives considered;
• details of any meetings or reviews offered;
• how the person can challenge or appeal the decision;
• how to make a complaint;
• who to contact for advocacy or independent advice;
• how continuity of care will be maintained; and
• confirmation that the notice relates only to the care and support agreement and not to any tenancy, licence or occupancy agreement.

Shorter notice or immediate termination must only be used where there is an immediate and serious risk to life, health, safety or wellbeing, or where a legal requirement, court order, safeguarding direction or regulatory requirement makes continued provision unsafe or unlawful.

8.2 Decision-Making Before Provider-Led Termination

Before {{org_field_name}} makes a provider-led decision to terminate an agreement, the Registered Manager or nominated senior manager must ensure that:

• the person has been involved as fully as possible;
• the person has received information in a format they can understand;
• capacity and consent have been considered;
• any best interests process has been completed where required;
• advocacy has been considered or arranged where appropriate;
• reasonable adjustments have been made;
• risks have been assessed and reviewed;
• safeguarding concerns have been referred where required;
• the commissioner, local authority, ICB, social worker or care coordinator has been informed where applicable;
• alternative providers or support options have been explored;
• staff safety and service user safety have both been considered;
• the decision is proportionate, non-discriminatory and evidence-based; and
• the decision and rationale have been recorded.

8.3 Supporting Service Users Through Transition

Where a care and support agreement is ended, {{org_field_name}} will take all reasonable steps to support a safe and planned transition. This includes working with the person, their representative, commissioner, local authority, ICB, social worker, care coordinator, advocate, family, housing provider and new provider where appropriate.

A transition plan must be completed where termination may affect the person’s safety, wellbeing, dignity, continuity of care, medication, personal care, nutrition, hydration, communication, finances, mental health, behaviour support, safeguarding arrangements or access to the community.

The transition plan should include:

• the final date and time of support from {{org_field_name}};
• the provider or person responsible for support after termination;
• how medication, personal care, meals, appointments and essential routines will be maintained;
• how risks will be managed during the handover period;
• what information will be shared and with whom;
• how the person’s consent or best interests decision has been obtained;
• how complaints, appeals or disputes will be handled; and
• contingency arrangements if the new support is delayed or fails.

8.4 Emergency Termination or Immediate Withdrawal

Immediate termination or withdrawal of support must only occur in exceptional circumstances where continuing the service would create an immediate and serious risk to life, health, safety or wellbeing, or would be unlawful. Examples may include serious violence or threats that cannot be safely managed, a court order, police direction, serious safeguarding risk, loss of lawful authority to provide the service, or circumstances where staff cannot safely enter or remain in the person’s home.

Before immediate termination or withdrawal, the Registered Manager or senior manager must, as far as reasonably practicable:

• complete and record an urgent risk assessment;
• consider whether the risk can be reduced by additional staffing, different staff, temporary changes, police support, clinical support, positive behaviour support, safeguarding action or commissioner intervention;
• notify the commissioner, local authority, ICB, safeguarding team, social worker, care coordinator or emergency services where appropriate;
• consider the person’s mental capacity, communication needs, disability-related needs and reasonable adjustments;
• ensure the person is not left without essential care where this would place them at avoidable risk;
• make or request urgent alternative care arrangements; and
• record the decision, rationale, people consulted and actions taken.

Where an incident meets the threshold for a CQC notification, safeguarding referral, police report, duty of candour notification or commissioner notification, this must be completed in line with the relevant policy and legal requirements.

8.5 Safeguarding and Non-Abandonment

{{org_field_name}} must not withdraw essential care in a way that leaves a person at avoidable risk of neglect, self-neglect, abuse, harm or deterioration. Where termination, suspension or reduction of support may create safeguarding risk, the Registered Manager must make a safeguarding referral or seek urgent advice from the local authority safeguarding team.

Where the person receives commissioned care, the commissioner must be informed at the earliest opportunity so that alternative care can be arranged. Where the person self-funds and there is a serious risk to their health, safety or wellbeing, the local authority must be contacted for advice under its adult safeguarding and care and support responsibilities.

8.6 Records and Evidence

All decisions to vary, suspend or terminate an agreement must be clearly recorded. Records must include the reason for the decision, assessment of risk, mental capacity considerations, consent or best interests decisions, reasonable adjustments, meetings held, people consulted, alternatives considered, notices issued, complaints or appeals received, safeguarding referrals, CQC notifications where applicable, transition arrangements and final outcome.

Records must be accurate, complete, contemporaneous, securely stored and available for audit, investigation, complaint response, safeguarding enquiry or CQC inspection.

9. Appeals, Complaints and Disputes

If a person or their representative disagrees with a decision to vary, suspend or terminate the care and support agreement, they may request a review of the decision and may make a complaint under the Complaints and Appeals Policy (SL14). Information about how to complain must be provided in an accessible format.

The person must be told how to access advocacy, independent advice and external complaint routes. Where the service is commissioned, the person may also complain to the commissioner or local authority. Where the person remains dissatisfied after the provider’s complaints process has been completed, they may be signposted to the Local Government and Social Care Ombudsman, or other relevant external body depending on the funding and commissioning arrangement.

A complaint or appeal does not automatically prevent termination where there is immediate serious risk, but {{org_field_name}} must consider whether the termination can safely be paused, varied or managed through interim arrangements while the concern is reviewed.

9.1 Duty of Candour

Where termination, suspension, withdrawal or transfer of support is connected to a notifiable safety incident, {{org_field_name}} will comply with the duty of candour. This includes acting in an open and transparent way, informing the person or relevant representative as soon as reasonably practicable, providing a truthful account of what is known, offering an apology where appropriate, explaining further enquiries or actions, and keeping a written record.

9.2 CQC Notifications and External Reporting

{{org_field_name}} will submit statutory notifications to CQC where required under the Care Quality Commission (Registration) Regulations 2009. This may include notifications relating to death, serious injury, abuse or allegations of abuse, incidents reported to or investigated by the police, events that stop or may stop the service from running safely, or other notifiable incidents.

The Registered Manager is responsible for ensuring that CQC notifications, safeguarding referrals, commissioner notifications, police reports and other external reports are completed accurately and within required timescales.

10. Legal and CQC Compliance
This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the Care Quality Commission (Registration) Regulations 2009 and CQC guidance for providers and managers.

This policy is particularly relevant to:

• Regulation 9: Person-centred care – agreements must reflect assessed needs, preferences, involvement, reasonable adjustments and lawful decision-making.
• Regulation 10: Dignity and respect – people must be treated respectfully and not threatened, coerced or unfairly disadvantaged when agreements are changed or ended.
• Regulation 11: Need for consent – consent, capacity and lawful representative authority must be considered before agreements are made, varied or ended.
• Regulation 12: Safe care and treatment – termination, suspension or transfer must be risk assessed and managed safely.
• Regulation 13: Safeguarding service users from abuse and improper treatment – withdrawal or termination must not expose people to abuse, neglect, self-neglect or avoidable harm.
• Regulation 16: Receiving and acting on complaints – people must be able to challenge decisions and raise concerns.
• Regulation 17: Good governance – decisions must be lawful, documented, audited and supported by accurate records.
• Regulation 18: Staffing – the provider must consider whether staffing levels, skills and competence can safely meet the agreement.
• Regulation 19: Fit and proper persons employed – only suitable staff must provide care and support.
• Regulation 20: Duty of candour – notifiable safety incidents must be handled openly and honestly.
• Regulation 20A: Display of performance assessments – where applicable, ratings and performance information must be displayed in accordance with CQC requirements.
• CQC Registration Regulations 2009 – statutory notifications, statement of purpose, changes and other registration requirements must be met.

For supported living, this policy must also be read in line with CQC guidance on the regulated activity of personal care and the requirement for a real separation between care and support arrangements and accommodation or occupancy arrangements.

11. Staff Responsibilities

All staff must understand that supported living care and support agreements are separate from housing or occupancy agreements. Staff must not tell or imply to a person that their home is at risk because they complain, refuse care, change provider or disagree with {{org_field_name}}.

Staff must escalate concerns about agreements, refusals of care, non-payment, safeguarding risks, family disputes, mental capacity, tenancy issues, complaints, staff safety or potential termination to the Registered Manager. Staff must keep accurate records and must not make promises, threats or informal arrangements that are inconsistent with the person’s agreement, care plan, tenancy rights, commissioning arrangements or legal rights.

12. Policy Review

This policy will be reviewed at least annually, or sooner where there are changes in legislation, CQC guidance, commissioning requirements, case law, safeguarding practice, operational risks, complaints, incidents, audit findings or service model. The Registered Manager is responsible for ensuring that the policy remains current and that staff understand and follow it.

Where changes affect people using the service, {{org_field_name}} will provide updated information in an accessible format and will explain any changes that may affect the person’s agreement, rights, choices, support arrangements or complaint routes.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.